ENDOSCOPIC ULTRASOUND-GUIDED ETHANOL ABLATION THERAPY FOR SOLID PANCREATIC TUMORS

Aims:

Endoscopic ultrasound-guided ethanol ablation (EUS-EA) is recently introduced for the treatment of pancreatic solid tumors. However, the effect and safeness of this treatment have not been well investigated yet. The aim of this study was to determine the feasibility, effect and complications of EUS-EA for pancreatic solid lesions.

Methods:

Between October 2015 and September 2017, 16 patients who underwent EUS-EA for small pancreatic neuroendocrine tumor (PNET) or solid pseudopapillary tumor (SPT) and followed up for more than 3 months were included. Complete remission was defined as no residual tumor in follow up imaging test. Their medical records were retrospectively reviewed.

Results:

The median age was 50 (18 – 72) years and the median follow-up duration after ablation was 185 (126 – 601) days. Nine patients had PNETs and seven patients had SPT. The median tumor size was 15 (8 – 23)mm. The median volume of ethanol injection was 1.1 (0.3 – 3)ml. After ethanol ablation, one case (6.3%) showed complete remission, 6 cases (37.5%) of size reduction, 6 cases (37.5%) of no change in size, and 3 cases (18.8%) of size increment. Adverse events related to procedure are as follows: 1 (6.3%) necrotizing pancreatitis, 1 (6.3%) mild acute pancreatitis, and 4 cases (25.0%) of self-limiting abdominal pain.

Conclusions:

The effect of EUS-EA for pancreatic solid lesions is limited compared to previous studies. Subsequent studies on the indications for this procedure and adequate amount of alcohol needed for tumor ablation will be needed.